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It does not require proof of efficacy in large trials the way we typically expect from drugs, but it facilitates prescribing, and that changes things a lot, because there wont be a black market anymore

J Clin Transl Res 2018;3:297-310

NAD + is reduced to NADH by gaining two electrons and a proton from substrates at multiple steps in the TCA cycle

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It belongs to a class of drugs known as GLP-1 receptor agonists, which work by stimulating insulin secretion, reducing glucose production, and slowing gastric emptying